Saturday, July 22, 2017
'When inspiration has become hidden, when we feel ready to give up, this is the time when healing can be found in the tenderness of pain itself...In the midst of loneliness, in the midst of fear in the middle of feeling misunderstood and rejection is the heartbeat of all things." --Pema Chodron
Last night my dream seemed so real that it felt like a memory rather than a dream. In my dream I was in a big city and I was walking with someone who was pointing out the long line of people in every block. The line went on and on. It reminded me of going to the movies in Toronto back in the fifties. There would often be a line to see a new movie that would wind around a city block. Waiting to see a new Disney movie, the atmosphere would be one of excitement. But in my dream this huge line was in the USA. It was filled with hungry, disheveled and desperate people waiting to be fed. Since waking I can't get the dream out of my head. A premonition? Symbolic of my frustration with the current political atmosphere? Or is it my frustration with the politics of infant feeding and how blinded people seem to be? Politically we are heading into hard times for everyone but the wealthy 1 per cent. The kind of economic and social policies being promulgated by a republican administration will in all likelihood create an economic recession and more likely a depression. Or maybe it is the food shortages/crisis in Venezuela that triggered my dream? Venezuela was once a wealthy country with much promise that is now in the midst of a serious food crisis. What was the cause of this crisis? A dictatorship? Who would have predicted that a wealthy country could be brought down so easily?
How prepared are people for such an event? We take for granted that our grocery stores will always have shelves full of food that we can buy. And that we will have the money to buy what is on the shelves. Or that if worse came to worse our benevolent and loving government would make sure we got fed. It is pretty clear to me that it is an illusion to believe in the benevolence of our current government. Maybe if you are white and wealthy and/or a corporation, you will be protected from the "slings and arrows of outrageous fortune." How much our current political scenery reminds me of Shakespeare's Hamlet. The political corruption, anti-women attitude ("Get thee to a nunnery," Hamlet says to Ophelia) and incestuous relationships in Hamlet; seemed far-fetched when I read it in my teen years. But now I feel that Shakespeare had great insight. Insight that is still relevant to this day and age.
And so I dreamed a dream and suddenly felt like writing in my blog. It has been a few months without any wish to write in this blog. Depressed by the state of the world, and depressed by my inability to communicate the importance of patenting of human milk components, I just drifted reading one horrible news article after another. I started a post to this blog in May and entitled it, Fed Up. It was about being fed up with the Fed Is Best organization. And I couldn't finish the post. It seemed irrelevant, like fighting against a run-out in the ocean. Amazing that the Academy of Breastfeeding Medicine lets the Fed Is Best kind of critics post their delusions to the Academy website. Not that I am for stopping their posts, because I believe in discussions, in the dialectic of thought. Just that when I post a response to some of Fed Is Best delusional thinking, there is no response. Blessed silence. So what I am saying is either on target or others just think I am crazy. Crazy? The patents are legal documents and the infant formula industry is either stating one crazy thing after another about human milk components being so beneficial or they are speaking some truths. Maybe its a mixture of lies and truth or science gone nuts. But I am in a state of Fed Up. And my dream last night triggered the thought that breastfeeding is a vital, dynamic necessity in a "world gone mad." We believe rather erroneously that nothing changes, that what has been, will continue to be. That the US will never face hunger or starvation of its populace. Yet even now in the US children go to bed hungry and homeless. Just it isn't visible poverty, so we are blinded to that reality. After Hurricane Katrina there were accounts of young babies dying in New Orleans because the mothers didn't have infant formula to fed them. If only, if only they had breastfed-the only worry would be that the mother has water and food. We seem to be blinded by the past, that the US is a prosperous nation. But of course that is a white prosperous nation. Nowadays poverty seems to be a crime as well as being black or brown or female. Heaven forbid you are a poor black female in this country. My dream made me realize how critical it is for breastfeeding to be promoted and protected in the US right now. The current government has made it obvious that if you fit into the criteria of being poor, nonwhite, female or of a religion other than Christian, no assistance will be available. Immigrants are to be scorned, some will be imprisoned and deported without a trial. Life is getting brutal for the have-nots. And for those who think that their middle-class status will save them from this savagery, please re-read history or better yet read Shakespeare.
"We are such stuff as dreams are made on..." The Tempest, William Shakespeare
And as Nestle says about its new infant formula patent,
"Mother's milk is recommended for all infants. However, in some cases breast feeding is inadequate or unsuccessful for medical reasons or the mother chooses not to breast feed. Infant formulas have been developed for these situations. However, bovine milk which is usually used as the basis of commercially available infant formulas has a much lower content of sialylated oligosaccharides than human milk. As the structure of human milk and the functions of the individual components thereof becomes better understood, it has become apparent that it may be desirable to improve the sialic acid content of infant formulas based on bovine milk. "
As Shakespeare said, "Dreams, indeed, are ambition, for the very substance of the ambitious is merely the shadow of a dream..." Time to rethink our current reality and work to protect those who will not be protected by a government bereft of concern for those in need.
Copyright 2017 Valerie W. McClain
Sunday, April 16, 2017
"If you insist upon fighting to protect me, or 'our' country, let it be understood, soberly and rationally between us, that you are fighting to gratify a sex Instinct which I cannot share; to procure benefits which I have not shared and probably will not share; but not to gratify my instincts, or protect either myself or my country. For, the outside will say, in fact, as a woman, I have no country. As a woman I want no country. As a woman, my country is the whole world..." --Virginia Woolf
"The mother of all bombs, the mother of all bombs, the mother of all bombs, the mother of all bombs;" the words echoed in my brain and I changed the news channel. But the mother of all bombs echoed and re-echoed on all the news stations. I shut the news off but the words continued to haunt me. The words bounced around in my mind till I wanted to scream. It's just words. Yet words have meaning and the ability to describe a reality; not my reality but a reality.
Mothers bring forth life. Bombs destroy life. Why do most men thrill to the missile launch of deadly weapons? The description of missiles and bombs seems to play upon a male's erotic or is it sadistic view of the world? Death and destruction while enjoying one's dinner. Satisfaction guaranteed or your money back. Oh wait bombs don't have any guarantees other than destruction, capitalism at its finest. Bombs are like the bully at the beach who gets enormous satisfaction from stomping the castle you built into oblivion. Only these kind of bombs not only stomp out the castle, they blow away lives into oblivion. And while it supposedly blows away the enemy, it also causes "collateral damage." Yes, collateral damage means it also kills civilians: men, women and children who are just bystanders in a world gone mad.
Normally a mother does not destroy others unless her babies are threatened. One never gets between a mother bear and her cubs because mothers protect their young. Bombs do not protect, they destroy. Are we humanizing an object to make it more palatable to the American public? Or are we using the word in a fit of rage, like how males tend to use the word, mother f-ker? Do Americans hate mothers so much that they equate mothers as a force of destruction or an epitaph to be thrown at others in fits of rage?
Maybe this imagery explains in some ways, why women, as mothers, are treated so poorly in our society. Pregnant women are expected to be employed until the day they go into labor. And then afterwards expected to go back to their jobs as soon as possible. They are expected to work 8-10 hours a day, go home take care of children and do a mountain of housework. Should we wonder why women get postpartum depression? Having had the luxury of staying home when my children were little, I can't imagine doing all that and coping with for example a baby that is up all night from teething or fevers. What man would put up with such demands on their life?
Women have become slaves to a society that gives them little to no value as contributing members of society. Our society does not even value women enough to give them equal pay. It is usually women who give up a job to stay home with the kids. And they pay for that economically, in lower social security payments when they retire. When they go back to employment they have lost seniority and many benefits that are derived from steady employment.
But more to the point of this blog regarding human milk component patents, our society is now collecting human milk from women. Compensation is pitiful, a mere token of its value in the biotech marketplace. Women donate their milk because marketing campaigns explain that premature infants need donor milk. No one asks why their mothers are not providing that milk or why its not enough milk? Nor do mothers ask how much of their donated milk goes to premature infants, how much for research, how much for products and patents that enrich industry. The breastfeeding community through social media continues to exhort mothers to donate their milk without regard to what this really means. And US breastfeeding organizations seem unaware of patenting or unwilling to make it part of any real discussion. Heaven forbid women question donating human milk. Yet to me this represents a form of female slavery and an invasion of privacy (because what some researchers are after is DNA, genes to manipulate, to patent, to own, to monopolize in the marketplace).
Like the Mother of all bombs, we mothers are destroyed by the actions of a society who believes that life is to be manipulated. We are used to self-destruct as well as to destroy others. But that isn't mothers. We are not the destructive force on this planet. We are used to promote a viewpoint of world domination through the pillaging and rape of our planet. Dismissing the ability of women to sustain life through their milk, creates the need for a substitute product. We are the ultimate natural resource that this culture is destroying.
Copyright 2017 Valerie W. McClain
The Pharm Woman Patent that started the mad race to genetically engineer human milk components to improve infant formula.
Patent #4977137 owned by Baylor College of Medicine, filed in 1987 and entitled, "Lactoferrin as a dietary ingredient promoting the growth of the gastrointestinal tract."
The patent states, "A substantial growth of the intestines of newborn animals takes place in the first one to three days after birth. For example, in newborn pigs who are nursed by the mother, there is a substantial growth, approximately eight to ten inches, of the intestines of the infant within the first few days after birth. In a large number of human newborns, who are not nursed by the mother but are placed on an infant's formula, this growth of the gastrointestinal tract during the first few days may not occur, and, as a result, the infant is predisposed to chronic intractable diarrhea which must be managed for a period of three or more months at considerable expense and discomfort to the infant."
And the patent goes on to explain:
"The present invention is based upon the discovery that milk lactoferrin as a dietary ingredient promotes the growth of the gastrointestinal tract when added to infant formula or given separately from the formula and thus reduces the occurrence of chronic diarrhea and may assist in the management of short-gut syndrome and avoids, at least to some extent, chronic intractable diarrhea of the infant. The lactoferrin may be from a nonhuman animal or human source. The milk containing the lactoferrin should not be processed, such as by pasturization or the lactoferrin processed, extracted, or purified by a process which destroys the effectiveness of the lactoferrin."
In the year 2000 Baylor College of Medicine filed another patent called, "Production of recombinant lactoferrin and lactoferrin polypeptides using cDNA sequences in various organisms." patent # 6635447
From the patent (recombinant means genetic engineering-recombining genes):
"The recombinant LF being a protein derived by recombinant techniques can be used in a variety of applications. The human gene can be transferred to mammalian systems such as cows and other agriculturally important animals and expressed in milk. The incorporation of a human lactoferrin gene and expression in the milk of animals can combat an iron deficiency typical in piglets. The inclusion of the human lactoferrin gene with expression should improve an animal's disease resistance to bacterial and viral infection. The tissue specific expression of human lactoferrin in mammary glands, for instance, would impart the bacteriocidal and virucidal benefit of the expressed gene to young feeding on the milk and would provide a production means for the secreted protein for therapeutic use."
Tuesday, March 14, 2017
"The search for a scapegoat is the easiest of all hunting expeditions."
--Dwight D. Eisenhower
(Forward Note from Valerie: In 1992 I was 9 months pregnant, when my son, was stillborn. During a weekly routine check prior to labor, my midwife could not find a heartbeat. I went to the hospital for an ultrasound and was told that my son had died. The grief I felt was overwhelming. I do believe that one never gets over grief, one learns to live with it. I am deeply saddened for other mothers who have lost their children, their babies. Reading the recent articles regarding the mom whose baby died and believes that the cause was due to exclusive breastfeeding, was upsetting. I feel that this mom's situation needs more discussion to correct some misconceptions. I do not want to add to this mom's grief. Exclusive breastfeeding is the standard, global recommendation by various health agencies. Blaming a mother or mothers for following those recommendations is victimizing, not only to this particular mother but to all mothers who wish to exclusively breastfeed their babies. My sincere sympathy to Jillian and Jarrod Johnson at the loss of their son, Landon.)
The headlines in the Washington Post read like the National Enquirer, "She listened to her doctors--and her baby died. Now she's warning others about breast-feeding." (3/8/2017) On the day before this article, the USA Today had similar scary headlines, "Breastfeeding mom didn't know she was starving her baby to death." (3/7/2017) I am finding it harder and harder to read newspapers this year and these two articles were particularly gut-wrenching. Both the news articles were about the Johnson family whose full term newborn had died at 19 days old. The infant, Landon, was born by c-section weighing 7lb., 7oz in February of 2012 in a Baby-Friendly hospital.*
*Baby-Friendly Hospital Intiative began in 1992 as a result of the Innocenti Declaration to promote hospital practices that promote exclusive breastfeeding. While exclusive breastfeeding is promoted. The 6th Step states, "Give newborn infants no food or drink other than breastmilk unless medically indicated." see http://www.who.int/nutrition/topics/bfhi/en/
The American Academy of Breastfeeding Medicine, protocol #3 regardingthe use of supplementary feedings in a healthy term breastfed infant dated revised 2009 states, that an infant's physician should be notified if an infant weight loss is greater than 7%. It also states that an "8-10% weight loss may be within normal limits,...indication for careful assessment and possible breastfeeding assistance."
C-sections (medscape article) and IVs (Journal of Perinatal Education) can cause significant weight loss in some babies.
Jillian, mother of Landon, felt pressured to exclusively breastfeed her infant by the hospital personnel. The mom states in both newspaper articles that Landon lost 9.7 % of his birth weight by day 3, when they were discharged. Twelve hours later he became unresponsive at home and his father did CPR. He was taken to the ER and hospitalized on life support and died a few weeks later. According to the Washington Post coroner records state that Landon, "died of hypoxic-ischemic encephalopathy, or brain injury caused by oxygen deprivation; cardiac arrest; and hypernatremic dehydration." The article also states that Dr. Christie del Castillo-Hegyl, physician and founder of Fed Is Best related that Landon, "was born by emergency c-section because he was not getting enough oxygen during labor."
The question I have is: was exclusive breastfeeding the cause of this tragedy? The parents believe this to be true. And the organization, Fed Is Best, obviously believes that exclusive breastfeeding is the risk. Where is the evidence that exclusive breastfeeding is a risky practice? Will promoting the use of infant formula in the early days for all breastfeeding newborns, save more infants? Or are there far greater risk factors in demonizing exclusive breastfeeding?
Media articles will never tell us the full story of events that lead to this infant's death. Laws of privacy, prevent the medical community from commenting on this situation. So there is a lot we do not know and the information provided in these news articles may or may not be accurate. But the information that was provided by these articles (at least 3 articles that came out around the same time), have me questioning the premise that exclusive breastfeeding was the cause of death.
In one of the articles Jillian states that the best advice she received was from a NICU doctor, who said to her, "breast is best but follow with a bottle." (People Bodies interview, 3/3/2017) The mother again mentions a NICU doctor in the Washington Post who told her that, "...he suspected Landon was so severely dehydrated that his heart had stopped beating." She asked the NICU doc what he meant by severely dehydrated since she was exclusively breastfeeding. She had been told in the hospital that, "her latch was great" and, "she was doing fine." In another article she stated that she had sore and bleeding nipples.
The implication by the NICU doctor's statements appears to me to be a subtle passing of blame for the death of the infant onto the mom. The mom in another article states that had she "only" given her baby one bottle, then he would still be alive (usatoday). We cannot know whether just one bottle would have saved this baby.
No physician should ever state or imply to a parent that a parent's positive action (exclusive breastfeeding is a well established positive action, promoted world-wide) is the cause of death of a child. Unjustified blame becomes undeserved shame and guilt. Over the years, I have heard various comments by medical professionals who have made some oddball statements about breastfeeding. One doc stated to a mom that the cause of pyloric stenosis is breastfeeding. What?? A physical defect one is born with is caused by breastfeeding? Really? So hearing that a NICU doc in a Baby-Friendly Hospital implied that exclusive breastfeeding caused this infant's death is not so surprising.
From my perspective having worked with breastfeeding mothers for some 26 years, I think the articles suggest to me that this mom did not get the assistance and care needed. Preventing problems requires a knowledge of how certain interventions or lack of intervening increase risks of infant morbidity and mortality and maternal morbidity and mortality.
Like nutrition education, breastfeeding education in medical schools is not a requirement. Unless the person going to medical school has an interest in nutrition or breastfeeding, it means that there is a huge knowledge gap in those who are medically trained. Most hospitals hire licensed nurses who will support breastfeeding in the postpartum period. Most times those hired do not just work with breastfeeding moms, they also maybe required to fill in other duties on the hospital floor. I was told by various hospital-based lactation consultants (who had varying credentials regarding breastfeeding support from IBCLC, CLC, to no credentials) that they had about 10 minutes to spend per mom who had given birth. I was floored by their time limits. I did home visits as a WIC Breastfeeding Peer Counselor Coordinator and in private practice. The least amount of time spent per mom was 1 hour, and the most was 2 hours (for complicated situations) and there was follow-up phone calls and even follow-up home visits. With assembly line care instituted by health care institutions, how can a standard 10 minutes spot serious problems? All breastfeeding assistance in medical facilities is not equivalent and often dependent upon experience and knowledge. Most moms do not know what the credentials mean nor the fact that anyone can call themselves a lactation consultant (although this may change, as various states consider licensing of IBCLCs). Although I question whether licensing will remedy situations like this.
If the media articles are correct and the mom's recollections are accurate (this happened 5 years ago), then I see some very obvious red flags. A first time mom or a first time breastfeeding mom is at higher risk for breastfeeding problems. Moms who are in this category often need more support and one on one time from an experienced breastfeeding assistant. Moms who have had c-sections are at higher risk for various problems. For example, babies of c-sectioned moms lose more weight than babies who are born vaginally. Standard hospital practice in 2012 would have been that a 7% or greater weight loss would mean that infant's physician would be notified and steps would be taken to observe whether interventions were needed. Maybe this was done but not mentioned in any of the articles.
Mothers who have sore and bleeding nipples always require an evaluation. It can be a simple fix, changing the position of babies or moms. It can also be very complex situation. Unrelenting soreness can cause weight loss in babies because pain slows the let down reflex (and milk release may be minimal). Nipple pain can be excruciating (lots of pain nerve endings). Engorgement can be part of the problem. IV's used in labor and delivery can cause edema in the nipple and breast making a baby's latch on impossible or very painful. Engorgement is never normal. Yet many people (as well as medical professionals) believe it is normal. What engorgement shows is mother/infant separation and/or an IV overload. C-sectioned moms are more likely to have longer mom/baby separations as well as lots of IV solutions. Certain drugs for pain relief in labor and delivery may cause a newborn to be excessively sleepy or uninterested in nursing. How a mom gives birth impacts breastfeeding either positively or negatively.
The Washington Post article stated that Dr Christie del Castillo-Hegi. co-founder of Fed is Best, stated that Jillian, the mom, had an emergency c-section due to oxygen deprivation. The mom stated that she had sore and bleeding nipples and 14 hours of marathon (nonstop) breastfeeding. The baby had 9.7% loss of birth weight on day 3. Mom was released from the hospital on day 3 and went home only to return to the ER "fewer than 12 hours later." (usatoday). The mom had found her baby not breathing and her husband performed CPR and baby Landon was rushed to the ER and died several weeks later. According to the Washington Post, the LA County Coroner records state the cause of death was hypoxic-ischemic encephalopathy, or brain injury caused by oxygen deprivation, cardiac arrest and hypernatremic dehydration.
It appears to me that it is possible that this baby might have been physically in trouble before the mother started exclusively breastfeeding, that lack of oxygen during labor may have damaged the infant. But that is speculation not facts. The reality is that, if there is any blame to give, it has to be placed on a medical staff who did not see all the red flags. The mom did what was expected of her by the institution, exclusive breastfeeding. And the institution's staff failed the mother by not recognizing the need for interventions.
Yes, it is easy after-the-fact to recognize those red flags. And that recognition may not have prevented this tragedy. But we cannot presume in a society that all parents have enough information and support to exclusively breastfeed their newborns. We cannot even presume that all medical communities have enough information to create a supportive breastfeeding environment in hospitals. Exclusive breastfeeding is not the problem. Blaming mothers for exclusively breastfeeding masks the real issues that surround current birthing and breastfeeding practices in medical environments. After all, breastfeeding like birth is not a medical issue, except for a small subset of women who have medical problems that complicate birth and breastfeeding. Blaming exclusive breastfeeding for tragic medical outcomes is an alternative fact. It is a big lie that may destroy breastfeeding and create a nation of mothers who already fear birth and now will fear breastfeeding.
Copyright 2017 Valerie W. McClain